In most of the liberal discussions of the recent police killings of unarmed black men, there is an underlying assumption that the police are supposed to protect and serve the population. That is, after all, what they were created to do. If only the normal, decent relations between the police and the community could be re-established, this problem could be resolved. Poor people in general are more likely to be the victims of crime than anyone else, this reasoning goes, and in that way, they are in more need than anyone else of police protection. Maybe there are a few bad apples, but if only the police weren’t so racist, or didn’t carry out policies like stop-and-frisk, or weren’t so afraid of black people, or shot fewer unarmed men, they could function as a useful service that we all need.

This liberal way of viewing the problem rests on a misunderstanding of the origins of the police and what they were created to do. The police were not created to protect and serve the population. They were not created to stop crime, at least not as most people understand it. And they were certainly not created to promote justice. They were created to protect the new form of wage-labor capitalism that emerged in the mid to late nineteenth century from the threat posed by that system’s offspring, the working class.

This is a blunt way of stating a nuanced truth, but sometimes nuance just serves to obfuscate.

Before the nineteenth century, there were no police forces that we would recognize as such anywhere in the world. In the Northern United States, there was a system of elected constables and sheriffs, much more responsible to the population in a very direct way than the police are today. In the South, the closest thing to a police force was the slave patrols. Then, as Northern cities grew and filled with mostly immigrant wage workers who were physically and socially separated from the ruling class, the wealthy elite who ran the various municipal governments hired hundreds and then thousands of armed men to impose order on the new working class neighborhoods.

Class conflict roiled late nineteenth century American cities like Chicago, which experienced major strikes and riots in 1867, 1877, 1886, and 1894. In each of these upheavals, the police attacked strikers with extreme violence, even if in 1877 and 1894 the U.S. Army played a bigger role in ultimately repressing the working class.

In the aftermath of these movements, the police increasingly presented themselves as a thin blue line protecting civilization, by which they meant bourgeois civilization, from the disorder of the working class. This ideology of order that developed in the late nineteenth century echoes down to today – except that today, poor black and Latino people are the main threat, rather than immigrant workers.

Of course, the ruling class did not get everything it wanted, and had to yield on many points to the immigrant workers it sought to control. This is why, for instance, municipal governments backed away from trying to stop Sunday drinking, and why they hired so many immigrant police officers, especially the Irish. But despite these concessions, businessmen organized themselves to make sure the police were increasingly isolated from democratic control, and established their own hierarchies, systems of governance, and rules of behavior. The police increasingly set themselves off from the population by donning uniforms, establishing their own rules for hiring, promotion, and firing, working to build a unique esprit des corps, and identifying themselves with order. And despite complaints about corruption and inefficiency, they gained more and more support from the ruling class, to the extent that in Chicago, for instance, businessmen donated money to buy the police rifles, artillery, Gatling guns, buildings, and money to establish a police pension out of their own pockets.

There was a never a time when the big city police neutrally enforced “the law,” or came anywhere close to that ideal (for that matter, the law itself has never been neutral). In the North, they mostly arrested people for the vaguely defined “crimes” of disorderly conduct and vagrancy throughout the nineteenth century. This meant that the police could arrest anyone they saw as a threat to “order.” In the post-bellum South, they enforced white supremacy and largely arrested black people on trumped-up charges in order to feed them into convict labor systems.

The violence the police carried out and their moral separation from those they patrolled were not the consequences of the brutality of individual officers, but were the consequences of careful policies designed to mold the police into a force that could use violence to deal with the social problems that accompanied the development of a wage-labor economy. For instance, in the short, sharp depression of the mid 1880s, Chicago was filled with prostitutes who worked the streets. Many policemen recognized that these prostitutes were generally impoverished women seeking a way to survive, and initially tolerated their behavior. But the police hierarchy insisted that the patrolmen do their duty whatever their feelings, and arrest these women, impose fines, and drive them off the streets and into brothels, where they could be ignored by some members of the elite and controlled by others. Similarly, in 1885, when Chicago began to experience a wave of strikes, some policemen sympathized with strikers. But once the police hierarchy and the mayor decided to break the strikes, policemen who refused to comply were fired. In these and a thousand similar ways, the police were molded into a force that would impose order on working class and poor people, whatever the individual feelings of the officers involved.

Though some patrolmen tried to be kind and others were openly brutal, police violence in the 1880s was not a case of a few bad apples – and neither is it today.

Much has changed since the creation of the police – most importantly the influx of black people into the Northern cities, the mid-twentieth century black movement, and the creation of the current system of mass incarceration in part as a response to that movement. But these changes did not lead to a fundamental shift in policing. They led to new policies designed to preserve fundamental continuities. The police were created to use violence to reconcile electoral democracy with industrial capitalism. Today, they are just one part of the “criminal justice” system which continues to play the same role. Their basic job is to enforce order among those with the most reason to resent the system – who in our society today are disproportionately poor black people.

A democratic police system is imaginable – one in which police are elected by and accountable to the people they patrol. But that is not what we have. And it’s not what the current system of policing was created to be.

If there is one positive lesson from the history of policing’s origins, it is that when workers organized, refused to submit or cooperate, and caused problems for the city governments, they could back the police off from the most galling of their activities. Murdering individual police officers, as happened in in Chicago on May 3rd 1886 and more recently in New York on December 20th, 2014, only reinforced those calling for harsh repression – a reaction we are beginning to see already. But resistance on a mass scale could force the police to hesitate. This happened in Chicago during the early 1880s, when the police pulled back from breaking strikes, hired immigrant officers, and tried to re-establish some credibility among the working class after their role in brutally crushing the 1877 upheaval.

The police might be backed off again if the reaction against the killings of Eric Garner, Michael Brown, Tamir Rice, and countless others continues. If they are, it will be a victory for those mobilizing today, and will save lives – though as long as this system that requires police violence to control a big share of its population survives, any change in police policy will be aimed at keeping the poor in line more effectively.

We shouldn’t expect the police to be something they’re not. As historians, we ought to know that origins matter, and the police were created by the ruling class to control working class and poor people, not help them. They’ve continued to play that role ever since.

Sam Mitrani is an Associate Professor of History at the College of DuPage. He earned his PhD from the University of Illinois at Chicago in 2009 and his book The Rise of the Chicago Police Department: Class and Conflict, 1850-1894 is available from the University of Illinois Press.

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If you were to write a dystopian comedy about healthcare with this plan, people would shout “No Way!” but here it is in real life: Long-term loans, like mortgages, to pay for treatment for diseases like cancer, and hepatitis C that are outrageously expensive because the drug companies can charge whatever they want. The authors comment “By estimating the post-treatment mortality rates of the patients and using statistical models to gauge the default characteristics of these loans, we demonstrate viability under current practical conditions,” (i.e. adjusting interest rates to reflect the proportion of patients who die before paying off the loan.) Never underestimate the ingenuity of capitalism in healthcare.

Kaiser Health News
March 29, 2016
Mortgages For Expensive Health Care? Some Experts Think It Can Work.
By Michelle Andrews

A Massachusetts Institute of Technology economist and Harvard oncologist have a proposal to get highly effective but prohibitively expensive drugs into consumers’ hands: health care installment loans.

Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.

Some consumer advocates and health insurance experts see it differently.

“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”

Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.

“This is a private sector stopgap way to deal with something right now,” said Lo.

Their proposal calls for the loans to be financed by a pool of investors who would buy bonds and equities issued by an organization that makes the loans to consumers.

While it’s “distasteful” to talk about patients mortgaging their lives for treatment, Lo said, they hope the proposal will spur change.

A crisis is building over the prices of new transformative therapies for cancer, hepatitis C virus infection, and rare diseases.. The clinical imperative is to offer these therapies as broadly and rapidly as possible. We propose a practical way to increase drug affordability through health care loans (HCLs) — the equivalent of mortgages for large health care expenses. HCLs allow patients in both multipayer and single-payer markets to access a broader set of therapeutics, including expensive short-duration treatments that are curative. HCLs also link payment to clinical benefit and should help lower per-patient cost while incentivizing the development of transformative therapies rather than those that offer small incremental advances. Moreover, we propose the use of securitization — a well-known financial engineering method — to finance a large diversified pool of HCLs through both debt and equity. Numerical simulations suggest that securitization is viable for a wide range of economic environments and cost parameters, allowing a much broader patient population to access transformative therapies while also aligning the interests of patients, payers, and the pharmaceutical industry.

The Role of Health Insurance

Large copays are antithetical to the very purpose of health insurance. Hence, our proposal for patients to cover these costs with HCLs is only a short-run bridging solution. A more sustainable and economically more efficient approach to address the high cost of transformative therapies is for insurance companies to cover these costs, spread the amortized costs across their policyholders, finance the upfront payments using securitization, and set premiums at the appropriate levels to cover these costs. In return for larger drug purchases, insurance companies would wield substantial leverage to negotiate lower prices. Also, insurers would presumably borrow at lower interest rates than would individual patients, further reducing the overall financing cost of these therapies.

Conclusion

The burden of upfront payment for curative therapies makes it challenging for public and private payers to afford universal access to potentially life-saving therapies. To address this issue, we considered a new financing paradigm in which portfolio theory and securitization techniques are used to finance HCLs whose repayment is linked to ongoing value. By estimating the post-treatment mortality rates of the patients and using statistical models to gauge the default characteristics of these loans, we demonstrate viability under current practical conditions. Securitization brings new participants (for example, pension funds, mutual funds, and life insurance companies) into the financing pool and helps transform a set of disjointed and sometimes competing interests into a more cooperative system focused on improving care.. HCLs, not unlike student loans, auto loans, and home mortgages, can improve access to the best health care for the less affluent.

Considering the extremely large burden of certain diseases, such as HCV, for which cures already exist, and the many transformative therapies on the horizon, developing more efficient financing methods is now a matter of life and death. Taking action is no longer a choice but has become a necessity.

So the answer to outrageously priced drugs is to pay for them through health care loans (HCLs) – the equivalent of mortgages – and then use securitization “to finance a large diversified pool of HCLs through both debt and equity.” Did we not learn anything from the subprime mortgage crisis? Just as securitization of subprime loans became a “necessity,” securitization of HCLs is now not only supposedly necessary to prevent personal insolvency, it is, according to Andrew Lo, et al, “a matter of life and death.”

In Lo’s words, “While it’s ‘distasteful’ to talk about patients mortgaging their lives for treatment, they hope the proposal will spur change.”

Oh my.

An improved Medicare for all with first dollar coverage would eliminate any need to consider such an inhumane concept.

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By Eric Blanc. In 1906, Finland became the world’s first nation to grant full female suffrage.[1] This watershed achievement for women was won by Finnish socialists during the revolutionary upheaval that swept the Czarist empire to which Finland belonged.

Yet this important history has been overlooked by both academics and activists. Abraham Ascher’s standard work on the 1905 revolution in Czarist Russia, for instance, completely omits any mention of Finnish suffrage and argues that “the efforts of women to achieve equality bore few concrete results during the revolution.”[2] In the few non-Finnish books that address the 1906 victory, the role of the socialist movement is generally marginalized: David Kirby writes that suffrage “was conceded virtually without a struggle” and Barbara Evans Clements portrays mainstream feminists like Alexandra Gripenberg as the suffrage battle’s main protagonists.[3]

The granting of universal suffrage owes far more to the class struggle…

One of the authors is a member of SF Taxpayers for Public Safety, which organizes against construction of a new jail in San Francisco when the seismically-unsafe Hall of Justice is torn down. Its research shows the present system already has sufficient capacity even after closing the Hall of Justice jails, because of the success of alternatives to incarceration. Almost 75% of SF jail inmates have not been convicted of anything, they are awaiting trial, and large proportion, probably half, are in jail because they cannot afford bail. Like mass incarceration across the nation, blacks and latins are hugely over-represented. For instance, the proportion of blacks in SF jails is ten times their proportion in the general population. For more information on SF Jails, see http://tinyurl.com/m9af8qx .

You may think jail is a place for convicted criminals. You would be wrong. In San Francisco, 85 percent of the roughly 1,300 inmates in county jail haven’t been convicted of anything. That’s more than 1,000 men and women. They are there not because they have been found guilty but because they simply cannot afford bail.

Despite our progressive reputation, California uses an ineffective, costly and outdated system to determine who stays in jail and who is released.

Earlier this year, San Francisco Superior Court judges raised the standard bail amounts for numerous crimes. The bail for contempt of court, for instance, jumped from $10,000 to $20,000.

These higher bails ensure that a poor person charged with even a minor crime will remain in jail, which costs taxpayers $140 per day, while a wealthy person will be able to afford to get out regardless of the severity of his or her charges. Being in custody means an increased likelihood of conviction. It means wearing jail garb instead of a suit in front of the jury. It means accepting a plea bargain just to get out to save your job or care for your children.

The use of bail also exacerbates racial disparities in the system. A recent report released by San Francisco’s Center on Criminal and Juvenile Justice cites a finding that the average bail for Latinos is more than $50,000, compared with $28,000 for whites. A recent study of 40 of the largest U.S. counties that found that, among those in jail because they could not afford bail, 27 percent were white, 36 percent African American and 44 percent Latino.

Non-monetary forms of pretrial release such as own-recognizance release or supervised pretrial release are underutilized in San Francisco because the Pretrial Diversion Project just doesn’t get enough support. With adequate funding, the program could hire the staff needed to make sure all people arrested are screened, their cases are presented to the court, and they are supervised to make sure they appear for hearings.

Evaluations of pretrial services in five Northern California counties found that their return-to-court rates were higher than the national average for release on bail. San Francisco topped the list at a 97 percent return rate for non-monetary pretrial release as compared with an 82 percent return rate for those who put up bail.

While monetary bail is not going to vanish as a pretrial release option, we need to be smarter about it. Several states have passed laws shifting the pretrial release process from a cash-based one to a risk-based one. A Maryland law requiring courts to use a risk-assessment tool to determine pretrial release options resulted in a 3 to 4 percent increase in the number of people released in the first year. While not a huge increase, it is a step in the right direction. We could do the same in California right now.

Jeff Adachi is the San Francisco public defender. Naneen Karraker is a member of San Francisco Taxpayers for Public Safety. She has worked for over 40 years on criminal justice matters locally, statewide and regionally, including pretrial release options, alternatives to incarceration and youth violence prevention.

The Sonoma, California DA who refused to charge the deputy who murdered Andy Lopez used a pro-police expert witness to justify her decision. The deputy has a history of violence and lying.

UPDATE: to get an idea of the atmosphere of intimidation in Santa Rosa about the Andy Lopez case, the July 11 2014 “Stop Mass Incarceration Bay Area” email list, (stopmassincarcerationbayarea@gmail.com), reports: “Three of Andy’s Youth, ages 13 and 14, were roughed up by the police after leaving the Tuesday rally. The activists in Santa Rosa have been working on get the facts of the story organized. I have been working through last night and this morning to see if lawyers can file a complaint against “sexual assault”. The behavior of the SR police was Extremely inappropriate. As the 3 young women begged the cops for a female officer to search them – the were told to “spread your legs. Spread your legs wide” followed by the officer kicking their legs out to a wide stance. The MALE office then ran his hands over the girls and into their pockets as they protested pleading to not be hurt and for a woman officer. If the plan goes right – There will be a press release tomorrow morning and they will file a claim with the City.”

SF Chronicle, Friday, July 11, 2014

Expert witness in toy-gun case has history of siding with police

Bob Egelko

Called on to investigate the fatal shooting of a toy-gun carrying 13-year-old boy by a sheriff’s deputy, Sonoma County District Attorney Jill Ravitch chose a consultant she described as “an independent, outside expert on human performance in high-stress encounters, such as officer-involved shootings.”

One quality of William Lewinski that Ravitch didn’t mention was his reliability to side with police.

Lewinski, whose website describes him as “one of the nation’s foremost authorities on reaction times and shooting dynamics,” divides his time between training police officers, researching their conduct and testifying on their behalf, usually to dispute accusations of wrongful shootings.

Since 1990, he has testified for police in more than 75 cases in the United States and several in Canada and Great Britain. The Police Firearms Officers Association in Britain honored him in 2009 with its first life-member award for his “commitment to firearms officers in the U.K.,” particularly two he helped to exonerate of murder charges.

One courtroom adversary, Pasadena attorney John C. Burton, who has clashed with Lewinski in two police-shooting cases, describes him as “an uncredentialed police expert who will say whatever they need to justify the situation.”

Had to keep firing

In the Sonoma County case, Deputy Erick Gelhaus shot Andy Lopez seven times on Oct. 22 as the teenager walked near his Santa Rosa home, carrying a plastic AK-47 rifle, its distinctive orange tip removed by a friend.

In his 14-page report, Lewinski found Gelhaus’ explanation supportable “to a high degree of scientific certainty.”

The rifle, he wrote, looked like the real thing from a distance, and Gelhaus had good reason to think his life was in danger when the boy started to turn toward him after being told to drop his gun. “From a behavioral science perspective and an action/reaction paradigm,” Lewinsky said, Gelhaus couldn’t wait until the gun was pointed at him, but had to fire, and keep firing, until the perceived threat was removed.

Lewinski said he reviewed statements by other witnesses, but interviewed only Gelhaus.

Likewise, he interviewed only one person – former BART police Officer Johannes Mehserle – before testifying at Mehserle’s murder trial for fatally shooting unarmed passenger Oscar Grant on an Oakland transit platform in January 2009.

Brought in as an expert witness on police psychology, Lewinski wasn’t allowed to say whether he thought the shooting was justified. But he told the jury in 2010 that factors such as “inattentional blindness” and “muscle memory”can cause an officer under stress like Mehserle to mistake his gun for a Taser, carried on the opposite hip, and to perceive that his captive may be armed and dangerous, even though he was lying face down with another officer kneeling on his shoulder.

The jury acquitted Mehserle of murder and convicted him of involuntary manslaughter. Lewinski also testified for Mehserle last month before a federal jury in San Francisco that found the officer had not violated Grant’s civil rights.

Weighed against other evidence in the two cases, Lewinski’s opinions don’t appear to be extreme. While protesters in Sonoma County continue to demand criminal charges against Gelhaus, they haven’t come up with evidence to contradict Lewinski’s conclusion that the officer thought Andy Lopez was carrying a real gun.

Stacking the deck?

The question that’s now being raised is whether Ravitch, the district attorney, was trying to stack the deck with her choice of consultants.

“He’s an opportunist who will say whatever is expedient to get the cop off, so why in the world would any reputable district attorney’s office rely on someone like him?”asked Oakland attorney Michael Haddad, who tangled with Lewinski over a 2000 police shooting in Oakland. Haddad is president of the National Police Accountability Project, a group of lawyers who sue police, often with the aid of their own experts.

Ravitch responded to an inquiry by listing Lewinski’s academic credentials.

Lewinski didn’t respond to requests for comment, but he’s replied to similar criticisms in the past, most recently after an office that reviews complaints against police in British Columbia said it would stop using him as an expert consultant. One official said Lewinski’s reports seemed biased.

“The science I share in the context of my work is held in the highest regard by top experts in the legal, academic and criminal justice communities worldwide, “Lewinski said in an August 2013 e-mail quoted by CBC News.

Pioneered the field

A native of Canada, Lewinski earned a doctorate from Union Institute, taking his courses online. He then pioneered – or, his critics would say, invented – the field of police psychology, founding a research center now called the Force Science Institute at the University of Minnesota at Mankato, where Lewinski was also a professor for 28 years.

Asked at last month’s Mehserle trial about the fees he charges as an expert witness, Lewinski did not give an exact figure, but said the payments include $475 an hour that goes to the institute.

He regularly testifies that police are justified in opening fire as soon as they perceive a potential threat and can’t wait until they see a gun pointed at them. If Gelhaus, in the Santa Rosa case, had waited until Andy Lopez had fully turned toward him, Lewinski wrote, “he could be shot at multiple times before he could respond.”

‘Shoot-first doctrine’

Lewinski’s shoot-first doctrine led to what he described as a major victory in the case of Anthony Dwain Lee, a Hollywood actor who was fatally shot in the back by a Los Angeles police officer at a Halloween party in 2000 after showing up in costume and pulling out a real-looking toy gun. After Lewinski’s research on reaction times showed that the officer could have been acting in self-defense, he said on his website, the family’s $100 million suit against the officer and the Los Angeles Police Department was settled for $225,000.

But there have also been defeats, like the case of Willie Wilkins, an undercover Oakland police officer shot to death by fellow officers as he tried to arrest a suspect in 2001.

Lewinski, hired as an expert by the city in a damage suit by Wilkins’ family, cast doubt on the testimony of other officers who claimed to have heard Wilkins identify himself before he was shot. Stress, he asserted, may have confused them or clouded their memories. Haddad, the family’s lawyer, challenged Lewinski at a lengthy deposition and said the witness wound up admitting that his confusion-under-stress theory would apply equally to the officers who fired the fatal shots.

The city settled the suit for $3.5 million.

Lewinski is “charming,” Haddad said in a recent interview, but “his opinions can be pretty flaky.”

SANTA ROSA — The Sonoma County sheriff’s deputy who shot and killed a 13-year-old boy after mistaking the youth’s replica gun for an assault rifle has a history of excessive force and questionable judgment, the teenager’s family said Tuesday in an amended lawsuit.

Deputy Erick Gelhaus had been involved in several controversial incidents long before he encountered and shot dead eighth-grader Andy Lopez in October, the suit said.

In 1996, Gelhaus pointed his gun at a woman “carrying her young son” after she had called for help in connection with a dispute with a neighbor, the suit said. “He chased her around her vehicle, causing her great fear and anxiety,” the complaint said.

Around that same year, Gelhaus and his partner were accused of falsifying police reports in a domestic violence matter, the suit said. The other deputy, whose name wasn’t released, was fired, according to the suit.

The suit also cites an incident in August, two months before the teenager was killed, in which Gelhaus allegedly pulled a gun on motorist Jeffrey Westbrook two times during a traffic stop on Highway 101 in Cotati. Westbrook told The Chronicle that the interaction troubled him so much that he recalled asking the deputy at one point, “Sir, is there something wrong with you?”

Sheriff’s officials “were long aware of the propensity of defendant Gelhaus to recklessly draw his firearm and to use excessive force,” said the suit, which the family first filed in November. The new allegations were added to the suit Tuesday.

Sheriff’s officials have not responded to the fresh allegations in court.

On Oct. 22, Gelhaus and a deputy he was training pulled up behind Andy, who was holding what turned out to be a replica AK-47 pellet gun in his left hand near his home outside Santa Rosa. A witness heard Gelhaus yell at the boy twice to drop the weapon, police said. Gelhaus has told investigators that he fired when the boy turned and the barrel of the rifle rose toward the deputies, he said.

An attorney for Gelhaus has said that the deputy “absolutely believed it was a real AK-47 and absolutely feared for his life.”

Gelhaus, an Iraq War veteran and frequent contributor to law enforcement magazines and online forums in which he promotes officer safety, “instructed and advised others on the use of questionable tactics, including recommendations as to how an officer must respond to justify shooting a kid with a toy gun,” the suit said.

After shooting the boy, Gelhaus deleted his online comments “in an effort to conceal his beliefs,” the suit said.

Gelhaus had not previously not fired on anyone in his 24 years with the Sheriff’s Office, where he has served as a field training officer for new recruits and trains colleagues to shoot at the department’s gun range. But the suit cites an incident in 1995 in which he accidentally shot himself in the leg while on duty, reportedly while holstering a gun.

After being arrested on a misdemeanor charge following a family dispute last year, Jose Bautista was unable to post $250 bail and ended up in a jail cell on Rikers Island.

A few days later, he tore his underwear, looped it around his neck and tried to hang himself from the cell’s highest bar. Four correction officers rushed in and cut him down. But instead of notifying medical personnel, they handcuffed Mr. Bautista, forced him to lie face down on the cell floor and began punching him with such force, according to New York City investigators, that he suffered a perforated bowel and needed emergency surgery.

Just a few weeks earlier, Andre Lane was locked in solitary confinement in a Rikers cellblock reserved for inmates with mental illnesses when he became angry at the guards for not giving him his dinner and splashed them with either water or urine. Correction officers handcuffed him to a gurney and transported him to a clinic examination room beyond the range of video cameras where, witnesses say, several guards beat him as members of the medical staff begged for them to stop. The next morning, the walls and cabinets of the examination room were still stained with Mr. Lane’s blood.

The assaults on Mr. Bautista and Mr. Lane were not isolated episodes. Brutal attacks by correction officers on inmates — particularly those with mental health issues — are common occurrences inside Rikers, the country’s second-largest jail, a four-month investigation by The New York Times found.

Reports of such abuses have seldom reached the outside world, even as alarm has grown this year over conditions at the sprawling jail complex. A dearth of whistle-blowers, coupled with the reluctance of the city’s Department of Correction to acknowledge the problem and the fact that guards are rarely punished, has kept the full extent of the violence hidden from public view.

But The Times uncovered details on scores of assaults through interviews with current and former inmates, correction officers and mental health clinicians at the jail, and by reviewing hundreds of pages of legal, investigative and jail records. Among the documents obtained by The Times was a secret internal study completed this year by the city’s Department of Health and Mental Hygiene, which handles medical care at Rikers, on violence by officers. The report helps lay bare the culture of brutality on the island and makes clear that it is inmates with mental illnesses who absorb the overwhelming brunt of the violence.

The study, which the health department refused to release under the state’s Freedom of Information Law, found that over an 11-month period last year, 129 inmates suffered “serious injuries” — ones beyond the capacity of doctors at the jail’s clinics to treat — in altercations with correction department staff members.

The report cataloged in exacting detail the severity of injuries suffered by inmates: fractures, wounds requiring stitches, head injuries and the like. But it also explored who the victims were. Most significantly, 77 percent of the seriously injured inmates had received a mental illness diagnosis.

Covering Jan. 1, 2013, to Nov. 30, 2013, the report included no names and had little by way of details about specific cases. But The Times was able to obtain specific information on all 129 cases and used it to take an in-depth look at 24 of the most serious incidents, including Mr. Bautista’s and Mr. Lane’s. The Times also examined numerous other attacks on inmates by jail employees uncovered independently of the report.

What emerges is a damning portrait of guards on Rikers Island, who are poorly equipped to deal with mental illness and instead repeatedly respond with overwhelming force to even minor provocations.

The report notes that health department staff members interviewed 80 of the 129 inmates after their altercations with correction officers. In 80 percent of the cases, inmates reported being beaten after they were handcuffed.

The study also contained hints of efforts to cover up the assaults. More than half of the inmates reported facing “interference or intimidation” from correction officers while seeking treatment after an altercation.

In five of the 129 cases, the beatings followed suicide attempts.

Many of the cases were similar to Mr. Bautista’s and Mr. Lane’s, in which several guards ganged up on a single inmate. At times, a slight aimed at a correction officer set off a chain of events that ended savagely.

While it was often hard to know what precipitated the altercation or who was at fault, the severity of the inmates’ injuries makes it clear that Rikers guards regularly failed to meet basic professional standards.

Even so, none of the officers involved in the 129 cases have been prosecuted at this point, according to information from the Bronx district attorney’s office. None have been brought up on formal administrative charges in connection to the cases so far either, though that process can sometimes be lengthy, and the Correction Department does not comment on pending investigations.

The assaults took place as guards have been struggling to contain surging violence at Rikers. The number of fights between inmates has increased year by year since at least 2009, according to Correction Department data. Assaults on correction officers and civilian staff members have also risen.

The growing numbers of mentally unstable inmates, with issues like depression, schizophrenia and bipolar disorder, are a major factor in the violence. Rikers now has about as many people with mental illnesses — roughly 4,000 of the 11,000 inmates — as all 24 psychiatric hospitals in New York State combined. They make up nearly 40 percent of the jail population, up from about 20 percent eight years ago.

The jail is not equipped for them. Inmates are housed on cellblocks supervised by uniformed men and women who are often poorly trained to deal with mental illness, and rely on pepper spray, take-down holds and fists to subdue them.

At Rikers, inmates with mental health problems are especially vulnerable, often the weakest in a kind of war of all against all, preyed upon by correction officers and other inmates. The prolonged isolation, extremes of hot and cold temperatures, interminable stretches of monotony punctuated by flashes of explosive violence can throw even the most mentally sound off balance and quickly overcome those whose mental grip is already tenuous.

Surrounded and overwhelmed, some withdraw into themselves. Others lash out. Almost daily, correction officers and civilian staff members are splashed with urine and other bodily fluids. And sometimes they are attacked. This year, two interns working in mental health units were assaulted. One suffered a broken nose, eye socket and jaw.

Inmates with mental illnesses commit two-thirds of the infractions in the jail, and they commit an overwhelming majority of assaults on jail staff members.

Yet, by law, they cannot be medicated involuntarily at the jail, and hospitals often refuse to accept them unless they harm themselves or others.

Shakima Smith-White drew a sharp contrast between how her son Michael Megginson, who has bipolar disorder, was treated during the three years he was committed to state psychiatric hospitals and the year he has spent at Rikers after being jailed on a robbery charge. “The hospital gave him a shot in his backside to knock him out, and then put him in a padded room for a few hours until he was calm,” she said.

At the jail, on Oct. 8, after a violent encounter with guards, he was found by clinicians curled up on the concrete floor of a holding cell, his wrist fractured, an eye swollen shut and bruises all over his body.

The violence continues to worsen, even as Mayor Bill de Blasio and his new reform-minded correction commissioner have vowed to bring Rikers Island under control. Correction officers used force on inmates 1,927 times in the first six months of 2014, an increase of more than one-third compared with the same period last year, according to Correction Department data. Use of force by officers is up nearly 90 percent over the last five years, even as the jail population has declined.

“There’s lots of brutality,” said Daniel Selling, who, until two months ago, was the director of the jail’s mental health services. “Horrible brutality.”

Four Guards, One Inmate

Conditions inside Rikers have rarely been a priority for city officials, but several recent episodes involving mentally disturbed inmates have heightened scrutiny of the jail complex and spurred calls for change. In February, a mentally ill homeless veteran died after the temperature in his cell reached more than 100 degrees. A month later, federal authorities indicted a correction officer on charges of violating the civil rights of an inmate with schizophrenia who swallowed toxic detergent and died, despite begging for medical attention for hours.

Those cases, however, reflected indifference and neglect. What the health department study documented was different: It showed that violence committed by guards against inmates is pervasive and routine.

Among the 129 inmates the study was based on, 45 had to be transported off the island to the emergency rooms of local hospitals for treatment. The rest were referred to an emergency service on the island.

Correction Department regulations say that a blow to the face or head should be the last resort when restraining an inmate. But that is exactly where inmates were injured in 73 percent of the violent encounters with officers. Just over a third of the assaults resulted in broken bones; more than 40 percent led to cuts that required stitches.

In August, Carlos Gonzalez, who suffered from depression and schizophrenia, was holding hands with his fiancée in a visiting area when a guard told him to let go. The guard threw him against a wall and told him to apologize for continuing to hold on, according to a Legal Aid Society complaint. In Mr. Gonzalez’s version of the events, he said he was sorry, but the guard told him to say it louder. When Mr. Gonzalez, who was arrested for violating an order of protection, refused, he said two guards punched him in the face. Mr. Gonzalez’s eardrum was ruptured, and he was so bloodied the guards made him change into a clean jumpsuit before he was taken to a clinic and later to Elmhurst Hospital Center.

In Brian Mack’s case, guards were allegedly settling a score. Mr. Mack, 57, who has been convicted of grand larceny, told investigators and health officials that he was assaulted in May 2013 by a captain and another officer after the captain challenged him over complaints he made about guards stealing inmates’ food. The captain struck him in the eye with his radio and the officer punched him in his jaw, Mr. Mack told investigators from the correction board.

Medical workers later reported that he had sustained “serious head trauma,” including a broken jaw and eye socket. Correction Department officials claimed Mr. Mack’s injuries came from a fight with other inmates, but board investigators could find no record of such a fight in the department’s log books.

In many of the cases examined by The Times, the guards’ responses seemed to grossly outweigh the perceived offense. The altercation involving Mr. Bautista early last year is especially puzzling.

After the four guards cut him down from his makeshift noose, he lay prone on the floor of the cell for nearly a minute but then suddenly stood up. Later Mr. Bautista, then 37 and a married father of five who made a living as a house painter and dishwasher, told investigators he did not know why he stood, except that he was confused.

At 5-foot-5, he is significantly smaller than the guards. Whether the four standing over him were startled, scared or angry is hard to know since the surveillance camera that caught much of what happened was unable to pick up sound. But this was the moment when they began wrestling with him and dragging him around the cell.

Later, investigators from four city agencies — the Board of Correction, the Department of Correction, the health department and the office of the medical examiner — watched the video, and all reached the same conclusion. “It can be clearly seen that officers are punching this inmate,” wrote Kennith Armstead of the Correction Board, which monitors conditions at Rikers and investigates serious incidents.

The pain was unbearable, said Mr. Bautista, who was later told he had depression.

“I felt all the strength going out of my legs and couldn’t stand up anymore,” he said in an interview. “My stomach felt really hot.”

Jail rules called for him to be transported to the clinic by gurney, but the officers half-walked, half-dragged him there.

Feces from the perforated bowel were leaching into his abdomen. “My stomach was swelling,” Mr. Bautista said.

In a few hours, he said, he was put into a van and thought he was going to the hospital, but instead was driven around and returned to the clinic.

There is a charade at Rikers, widely known by jail employees and jokingly referred to by some as “bus therapy” — where guards will load an inmate they do not want around into a van and drive him in circles.

This may have been what happened to Mr. Bautista. The jail log had him leaving the clinic at 5:45 p.m. on Jan. 11 and being admitted to Elmhurst Hospital Center at 2:47 a.m. on Jan. 12, according to investigators.

It is a 15-minute drive.

Mr. Bautista said it was past midnight when a second van ride took him to the hospital.

When he reached the emergency room, he asked to call his wife but was told by doctors there was no time: He was in danger of dying.

In the written account that the four officers filed within an hour of the incident, none reported being injured.

They described what happened as routine, that they had used standard body holds, “guided” him to the floor, applied flex-cuffs, “assisted Bautista to his feet,” and escorted him to the clinic.

That likely would have ended it, except that two weeks later, the board investigator was paging through a stack of injury reports when he noticed No. 828, Mr. Bautista’s case. Written across the bottom were the words “small bowel perforation” and “sent out via E.M.S. for a life-threatening emergency.”

Investigators from the Correction Department interviewed nine witnesses, repeatedly reviewed the video and concluded that Officer Kevin Barnaby had punched Mr. Bautista several times in the side.

Officer Barnaby denied this. He told investigators that it was Mr. Bautista who had started the fight by “rolling around squirming and attempting to bite” them. He said what looked like punches was him “trying to get Bautista’s hands out to be cuffed.”

In February, investigators recommended filing administrative charges against Mr. Barnaby, writing that besides using excessive force, he had filed a false report and given false testimony.

They were overruled. Two deputy commissioners in the Correction Department, Florence Finkle and Thomas Bergdall, determined that notwithstanding the serious injury, the force used was not excessive and did not violate the department’s policies, a spokesman said. They concluded, according to a department report, that Officer Barnaby “might have actually believed he was trying to grab Bautista’s arms out from under him.” The city’s Department of Investigation and the United States attorney’s office both reviewed the case and decided not to bring criminal charges.

In the end, the only person punished for the altercation was Mr. Bautista, who received an infraction for “physically resisting staff.”

He spent about a week in the hospital and then was released from Rikers. His misdemeanor charge was dropped soon after, and he has filed a lawsuit against the Correction Department. From the surgery, he has a foot-long scar down his stomach, which, he says, still causes him pain if the weather is bad or if he turns too quickly.

A Promise of Change

Rikers is far from alone as a correctional institution struggling with an influx of inmates with mental illnesses. According to some studies, correctional facilities now hold 95 percent of all institutionalized people with mental illnesses.

Some jails have learned to cope. In San Francisco, for instance, officers are taught to use “verbal judo”— tactics to talk an inmate down in order to de-escalate a crisis — and to ignore an inmate’s taunts if that is what it takes to keep peace.

In New York, by contrast, guards’ responses sometimes look more like street justice.

At a recent City Council hearing about problems at Rikers, Joseph Ponte, who took over as the city’s correction commissioner in April, acknowledged the department he inherited was “deeply troubled.”

He came to New York with a reputation as a reformer after spending three years as the correction commissioner in Maine, where he reduced the use of solitary confinement and overhauled mental health care in the state

Taming the violence at Rikers will not be so easy.

In an interview about The Times’s findings, Mr. Ponte acknowledged that Rikers was in need of change to “really bring it into the 21st century.”

He said policies governing when correction officers can use force were outdated and would be rewritten by the fall. Rookie officers, who have almost no on-the-job training after the academy, often did not know when to use force and how to de-escalate confrontations rather than use violence, he said. The new budget included funding for 12 new training captains to help mentor rookie officers going forward. The department also plans to increase the number of security cameras, which have been shown to reduce violence. They currently cover 42 percent of the jail space where officers interact, according to the Department of Correction.

Mr. Ponte said it was a minority of correction officers who engaged in brutal behavior.

“We really don’t have a culture of violence,” he said. “We have problems and we’re working to address those.”

Mr. Ponte has devoted particular attention to mental health in his first few months in New York, promising to work closely with the health department in changing Rikers.

He appears to have strong backing from the mayor, who appropriated $32 million in the new budget for mental health programs and more correction officers. At a Board of Correction meeting last Tuesday, Mr. Ponte said he planned to use some of that funding for staffing 370 new units to house the jail’s most violent inmates, including 120 who have mental illnesses.

In June, Mr. de Blasio also created a task force to study ways to improve care for people with mental illnesses cycling in and out of the criminal justice system.

Jail staff members complain they do not have the tools to properly care for inmates with mental health problems. Health privacy laws prevent uniformed officers from getting information they could use to better do their jobs, including knowing whether an inmate is taking his medication.

Mental health clinicians are unable to involuntarily medicate inmates who go off medication and often do not have access to the full range of drugs available outside the jail. Many clinicians complain that they are working in a setting that is controlled by correction officials who do not understand mental illness.

In January, the Department of Correction announced it was ending the use of solitary confinement for the inmates classified as “seriously mentally ill,” because it can exacerbate their conditions, and instead would provide them with more therapy. But the definition of “seriously mentally ill” includes only a small percentage of inmates who have received particular diagnoses, like schizophrenia or bipolar disorder, and meet certain criteria relating to their condition. A vast majority of inmates with mental health issues, even significant ones, can still be sent to solitary and make up more than half of the inmates in those cellblocks.

Under Mr. Ponte, the Correction Department recently moved to ensure its officers received more mental health training at the Correction Academy, adding an additional eight hours to the 38.5 hours trainees previously received.

Even so, it is clear from interviews that many guards harbor a deep skepticism for the purported mental health conditions of inmates.

“About half are faking it,” said one officer, who has worked on a mental observation unit most of his 10 years at Rikers and asked that his name not be used because he was not authorized to speak to the news media.

There is little chance for significant change at Rikers without the correction officers’ union on board, and Norman Seabrook, its president, has made it very clear that he is not. He has accused the health department of undermining security at the jail with its efforts to curtail the use of solitary confinement and divert more inmates to therapy.

For 19 years, Mr. Seabrook has headed the Correction Officers’ Benevolent Association, becoming one of the most powerful labor leaders in the state and exerting a control over the 9,000 rank-and-file members in a way that is rare today.

In an interview, he said he tried to instruct his members to use force judiciously.

“Do I have a correction officer here or there that goes over and beyond? I’m not going to say that I don’t,” he said. “That’s just like having a police officer that fires 41 shots.”

But he said that for every violent guard, there are those who are victims of attacks by inmates. Correction officers go to the hospital with injuries every day, he said.

“What about the officer that has a broken eye socket?” Mr. Seabrook said. “What about the officer that has a concussion? What about the officer that has their finger bitten off from these same individuals that people want to talk about as so so innocent?”

Tensions over how to handle inmates with mental illnesses surfaced recently while Mr. Ponte, Mr. Seabrook and Dr. Mary Travis Bassett, the health commissioner, were touring the Central Punitive Segregation Unit at Rikers. Inmates there are locked in solitary for 23 hours a day. As health officials were explaining the screening process that is supposed to be used before an inmate with a mental illness is placed in segregation, Mr. Seabrook erupted, according to two people who were there.

He asked Dr. Bassett how she would feel if his officers suddenly disappeared from the cellblock, leaving her alone with 100 vicious inmates — and then he answered his own question.

You’d be soiling your pants, he told her. (His words were more graphic.)

“This jail belongs to us,” Mr. Seabrook yelled. “It does not belong to the department of mental health.”

Anger on Both Sides of Bars

Whether correction officials should be able to send troublesome inmates with mental illnesses to solitary confinement and how long they should be confined there is one of the thorniest issues facing correction officials, not just in New York but across the country.

Studies have made clear that prolonged isolation can have a devastating effect on those with psychiatric issues, but even mental health workers at Rikers have fretted over the recent scaling back of the use of solitary at the jail, worrying dangerous inmates will be able to operate with impunity.

What is clear from the health department study is that assaults on inmates in the solitary confinement units are especially common, accounting for nearly a third of the serious injuries. Inmates there are so desperate to be let out of the cell that some will pound on their doors, scream, even cut themselves in hopes of getting a meeting with a social worker and an hour out of their cells.

A lot of the guards are not happy about being there, either. Several interviewed said they worked at Rikers because it pays a good union wage with pension benefits. When asked about the job itself, repeatedly the answer was, “I hate it.”

That can make for a lot of angry people in very tight quarters.

In March 2013, Luis Rosario got into a verbal back-and-forth with two officers and a captain in a solitary confinement unit for inmates with mental illnesses. After dragging him from his cell, one officer held him by his handcuffs and the other beat him, while their captain looked on, according to a complaint he filed with Correction Department investigators. The bones in Mr. Rosario’s face were so badly broken he needed his jaw wired shut.

Correction officers are supposed to show restraint, but in a place that has been growing more violent by the year, a code of behavior based on an eye for an eye appears to have taken hold.

This was the case on the night of Dec. 17, 2012, when an inmate flooded Cellblock 13B, a solitary confinement unit in the George R. Vierno Center at Rikers. Dinner was delayed, and inmates were told there might not be any dinner; vicious threats were exchanged between inmates and guards.

Correction officers removed two inmates, Tamel Dixon, 20, and Mr. Lane, 24, from their cells. Mr. Dixon, who had been arrested on charges of stealing cellphones, was dragged out first.

Officer Lameen Barnes prepared the official incident report that night on what happened to Mr. Dixon, writing that he had tried to throw an “unknown liquid substance” at the officers, and in response, they had searched his cell for contraband. When they entered, the report said, Mr. Dixon refused to come out, insulted them and would not follow their orders. He was restrained and handcuffed to a gurney.

“Once on his feet, inmate Dixon was eventually escorted to the main clinic for medical examination without any further incident of force used,” Mr. Barnes wrote.

That is nothing like what actually happened, according to accounts from three people who were there. Two requested anonymity because they said they feared retaliation from officers as well as their employer, Corizon, which has a contract with the city to provide health care at the jail. For the third witness, The Times was provided a copy of the clinician’s email to superiors about the incident, on the condition that the sender’s name be withheld.

According to their accounts, a group of correction officers wheeled Mr. Dixon into an examination area without a security camera. “Don’t leave me,” he kept yelling to the medics and social workers. “They’re going to kill me.”

About a half-dozen guards were crowded around the gurney, and one kept punching Mr. Dixon in the head.

Next, the correction officers brought in Mr. Lane, who had also splashed guards with a liquid. Mr. Lane was known as a disruptive inmate. He had been in and out of Rikers, and much of his most recent stint had been spent in solitary confinement. Born to a mother who was a crack addict, he spent most of his time growing up in foster homes and had a lengthy history of mental health problems, with diagnoses for schizophrenia, bipolar disorder, depression and attention deficit disorder.

“They punched me in the face and they kept punching me and punching me and punching me,” Mr. Lane recalled in an interview at Elmira Correctional Facility, where he recently completed a two-year sentence for a credit card theft conviction.

Two captains, Budnarine Behari and Rod Marcel, oversaw the guards in the beatings, the clinic workers who were there said.

“This one much worse and longer,” the email from the clinician said. “Staff members were visibly upset and some said they were sick to their stomachs.”

When staff members pleaded with them to stop, Captain Behari asked how they would feel if they had been splashed with urine, witnesses said.

Captain Behari was involved in another beating eight months earlier in which an inmate’s jaw and nose were broken. Administrative charges were brought against him but the verdict is still pending, more than two years later. A spokesman for the Bronx district attorney’s office said it was investigating the captains in the clinic case. But three witnesses told The Times they have not talked to anyone from the prosecutor’s office in a year.

Patrick Ferraiuolo, president of the captains’ union at Rikers, said both captains were placed on modified duty seven months after the clinic incident, collecting full pay, but assigned to jobs that did not involve contact with inmates. Neither of the captains had been interviewed by prosecutors, he said, because they had acted appropriately.

“How can I be resisting when I’m cuffed to the gurney?” Mr. Lane said.

“One officer took a knuckle brace and put it on his hands, just started hitting me, boom, boom,” he said. “My head started leaking blood, and that’s when I started getting dizzy and dizzy and dizzy,” he said, adding that he eventually passed out.

When he came to, he said, “I’m bloodied up, my teeth is all bloody, my mouth is all bloody. I got blood all down my throat.”

The next morning, when the day shift arrived, there was still blood splattered around examination room No. 6.

We, as members of the Gray Panthers of San Francisco, demand the City not press charges against MUNI drivers or their union and give drivers a fair contract.

MTA’s proposed wage increases, together with increased health and pension costs, will result in a net loss in pay for drivers, who have not had a pay raise for four years, yet MTA has given up millions in parking revenue and still has a budget surplus. The contract proposal contains permanently lower wages for new hires, an affront to our principles of inter-generational solidarity. The City’s charge against the union of delaying the ratification vote is based on the expectation that the drivers would be forced to vote before they had time to consider the implications of the proposed agreement. Similarly, the charge of delaying arbitration is based on the expectation that the union would submit to a process with a pre-determined outcome without any resistance.

Proposition G puts MUNI drivers in an impossible position: Wages must be determined by collective bargaining, but the City Charter prohibits them from striking. If drivers reject any contract proposal by MTA management, no matter how outrageous, the dispute must go to binding arbitration, which must side with management unless the arbitrator decides the drivers’ interests “outweighs the public interest in efficient and reliable transit.” Under these circumstances, drivers must accept whatever management proposes, or stage a sickout. What did the City expect to happen?

By taking actions against drivers and their union, the City is actively participating in a coercive labor process that will ultimately bring wider and more disruptive conflict to San Francisco. In an economic environment where San Francisco is unaffordable for its workers, and has the fastest-growing gap between rich and poor, it would be wise to realize that workers will not accept this treatment indefinitely.

The City’s mass media has long slandered drivers as greedy, incompetent, and rude, for performing some of the most difficult driving assignments in the country, but do not count on the media’s ability to permanently turn the community against MUNI workers. Members of the biggest union of the most poorly-paid City workers’ union are also in negotiations, and are angry at the City’s determination to hold wage increases down in the face of rising inflation, a budget surplus, and millions of dollars in tax breaks to tech companies. Times can change. Times will change.

Do not press charges against MUNI drivers or their union and give drivers a fair contract.